Growth Failure in Children Overview

Growth failure is a term used to describe a growth rate that is below the appropriate growth velocity (speed) for age. The term growth delay may refer to a situation in which a child is short but appears to be able to grow longer than children usually do, and thus, may not end up short as an adult. Dwarfism is a term that has often been used to describe extreme short stature; however, the term is unflattering and its use is often avoided. Growth hormone deficiency is sometimes called pituitary dwarfism.

Short stature may be a normal expression of a person's genetic potential and, therefore, the growth rate is normal. Short stature may also be a result of a condition that causes growth failure and a growth rate that is slower than normal.

A child is considered to be short if he or she has a height below the 3rd or 5th percentile on a growth chart.
A low percentage of all children are considered to be short. However, many of these children have normal growth velocities. The children who fall into this group include those with familial short stature or constitutional growth delay. Those with familial short stature are born with genes that determine their short height, and they usually have parents who are short. Constitutional growth delay is a term used to describe children who are small for their age but who have a normal growth rate. Of all children with short stature, only a few have a specific treatable medical condition.

The most rapid phase of growth occurs in the mother's uterus. After birth, the growth rate gradually declines over the first several years of life. At birth, the average length of a newborn is 20 inches; at 1 year, the average height is about 30 inches; at 2 years, the average height is about 35 inches; and at 3 years, the average height is about 38 inches. After 3 years and until puberty, linear growth continues at a relatively constant rate of 2 inches per year.

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Short stature may be the normal expression of genetic potential, in which case the growth rate is normal, or it may be the result of a condition that causes growth failure with a lower-than-normal growth rate.